“A STUDY OF CORRELATION BETWEEN CLINICAL FEATURES, RADIOLOGICAL FINDINGS AND SPIROMETRY PARAMETERS IN PATIENTS OF BRONCHIECTASIS”

INTRODUCTION: Bronchiectasis is dened as an irreversible dilation and destruction of one or more bronchi with a reduction in clearance of secretions and in the expiratory airow. Etiologies include prior lung infection, systemic inammatory disorders, and genetic disorders of host defense. METHODOLOGY: This is an Observational study of 160 patients patient who were diagnosed with Bronchiectasis in tertiary health care centre over a period of 15 months. Data was collected and analyzed for correlation between clinical features, radiological ndings and spirometry parameters. RESULT: Mean age of presentation was 21-30 years. Most important etiology was post-infections, pulmonary tuberculosis followed by pneumonia. The cardinal symptoms of bronchiectasis were productive cough followed by dyspnoea on exertion. The most common bacteria isolated from sputum culture was Haemophilus Inuenzae. The commonest radiological pattern of bronchiectasis was cylindrical followed by cystic and varicose. Most of the patients had obstructive pattern in spirometry tests. CONCLUSION: Radiological ndings and spirometry test are more valuable for early and accurate diagnosis of bronchiectasis which help in early and prompt management. Cases of bronchiectasis have repeated history of admissions in the hospital thus all options of treatment including surgical intervention must be taken into consideration for good quality life and healthy.

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Clinical features of atypical tuberculosis mimicking bacterial pneumonia

Open Medicine ◽

10.1515/med-2021-0349 ◽

2021 ◽

Vol 16 (1) ◽

pp. 1608-1615

Author(s):

Min Qi ◽

Pei-Jun Li ◽

Ye Wang ◽

Zong-An Liang

Keyword(s):

Multivariate Analysis ◽

Pulmonary Tuberculosis ◽

Clinical Features ◽

Bacterial Pneumonia ◽

Common Symptom ◽

Imaging Features ◽

Radiological Findings ◽

Pulmonary Atelectasis ◽

Radiological Features ◽

Radiological Pattern

Abstract Objectives The aim of this study is to investigate clinical features of atypical pulmonary tuberculosis (aPTB) mimicking bacterial pneumonia, determine imaging features with the highest degree of correlation, and identify predictors for acid-fast bacilli (AFB) positivity. Methods The clinical data of 259 patients considered as aPTB were retrospectively analyzed. The correlation of CT patterns was evaluated with Spearman analysis, and the predictors for AFB positivity were assessed with the multivariate analysis. Results The most common symptom of aPTB was cough (84.6%), followed by fever and anorexia (47.1 and 41.7%, respectively). Infiltrated patchy was the most common radiological pattern (84.9%), followed by nodules (3–10 mm), micronodules (<3 mm), and consolidation (79.2, 78.8, and 66.0%, respectively). Nodules (3–10 mm) and micronodules (r = 0.988, p < 0.001), consolidation and air bronchogram (r = 0.590, p < 0.001), and pulmonary atelectasis and consolidation (r = 0.323, p < 0.001) showed high correlation. In the multivariate analysis, hyperpyrexia (OR, 2.29; 95% CI, 1.22–4.29) and bronchiectasis (OR, 2.06; 95% CI, 1.04–4.06) were the predictors of AFB-smear positivity, while bulla (OR, 0.22; 95% CI, 0.05–0.97) was the predictor of AFB-smear negativity. Conclusion This study demonstrated the clinical and radiological features of aPTB mimicking pneumonia. Several paired radiological findings may guide us to the diagnosis of aPTB. Hyperpyrexia and bronchiectasis may be helpful for predicting AFB positivity, and bulla may be a predictive sign of AFB negativity.

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Testicular torsion: a scrotal catastrophe

International Surgery Journal ◽

10.18203/2349-2902.isj20193118 ◽

2019 ◽

Vol 6 (8) ◽

pp. 2959

Author(s):

Ketan Vagholkar ◽

Shantanu Chandrashekhar ◽

Dhairya Chitalia ◽

Shubhi Bhatnagar ◽

Sreyasvi Sibbadi

Keyword(s):

Clinical Features ◽

Testicular Torsion ◽

Surgical Intervention ◽

Negative Impact ◽

Clinical Signs ◽

Sudden Onset ◽

Testicular Pain ◽

History Of ◽

Red Flag ◽

Potential Loss

Testicular torsion is a serious scrotal emergency having a negative impact on fertility and in its most severe presentation, there is potential loss of the testicle if not diagnosed early. The condition needs to be diagnosed promptly with immediate surgical intervention. Intermittent testicular torsion (ITT) is a forerunner or a red flag for an impending frank testicular torsion. ITT is characterized by sudden onset of testicular pain which may resolve spontaneously before further investigation and treatment. Testicular torsion in adults is usually intravaginal in location and can be diagnosed clinically if the patient presents early with typical clinical signs. A case of ITT who presented with frank unilateral testicular torsion diagnosed clinically and surgically treated with salvage of the affected testes is presented to highlight the importance of history of ITT and typical clinical features. The anatomical aspects and pathophysiology of testicular torsion including the aftermath is discussed. ITT is a forerunner to frank testicular torsion. If offered prophylactic orchidopexy then a frank episode of testicular torsion with all its sequelae can be averted.

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A study of clinical features and factors associated with oral sub mucous fibrosis at tertiary health care centre

MedPulse International Journal of ENT ◽

10.26611/1016924 ◽

2019 ◽

Vol 9 (2) ◽

pp. 54-57

Author(s):

Pramod Kumar ◽

◽

Om Prakash ◽

Keyword(s):

Health Care ◽

Clinical Features ◽

Care Centre ◽

Health Care Centre ◽

Factors Associated ◽

Oral Sub Mucous Fibrosis

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Dysbaric osteonecrosis associated with decompression sickness in a fishing diver

Undersea and Hyperbaric Medicine ◽

10.22462/04.06.2019.17 ◽

2019 ◽

pp. 217-220

Author(s):

Eduardo Briceño-Souza ◽

◽

Nina Méndez-Domínguez ◽

Ricardo j Cárdenas-Dajda ◽

Walter Chin ◽

...

Keyword(s):

Femoral Head ◽

Decompression Sickness ◽

Small Scale ◽

Prior History ◽

Radiological Findings ◽

Small Scale Fisheries ◽

Left Limb ◽

History Of ◽

Decompression Stress ◽

Probable Diagnosis

Diving as a method of fishing is used worldwide in small-scale fisheries. However, one of the main causes of morbidity and mortality among fishermen is decompression sickness (DCS). We report the case of a 46-year-old male fisherman diver who presented with chronic inguinal pain that radiated to the lower left limb. Living and working in a fishing port in Yucatan, he had a prior history of DCS. A diagnosis of avascular necrosis in the left femoral head secondary to DCS was made via analysis of clinical and radiological findings. The necrosis was surgically resolved by a total hip arthroplasty. Dysbaric osteonecrosis is a more probable diagnosis. In this region fishermen undergo significant decompression stress in their daily fishing efforts. Further studies regarding prevalence of dysbaric osteonecrosis among small-scale fisheries divers are needed. In a community where DCS is endemic and has become an epidemic, as of late, the perception of this health risk remains low. Furthermore, training and decompression technique are lacking among the fishing communities.

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COVID-19 in a Cohort of Patients with Congenital Myasthenic Syndrome

Journal of Neuromuscular Diseases ◽

10.3233/jnd-210699 ◽

2021 ◽

pp. 1-3

Author(s):

Setareh Alabaf ◽

Karen O'Connell ◽

Sithara Ramdas ◽

David Beeson ◽

Jacqueline Palace

Keyword(s):

High Risk ◽

Neuromuscular Transmission ◽

Genetic Disorders ◽

Severe Disease ◽

Congenital Myasthenic Syndrome ◽

Referral Centre ◽

History Of ◽

Myasthenic Syndrome ◽

The Uk ◽

Rare Group

Congenital Myasthenic Syndrome (CMS) are a rare group of genetic disorders of neuromuscular transmission. Some subtypes of CMS can be associated with respiratory and bulbar weakness and these patients may therefore be at high risk of developing a severe disease from COVID-19. We screened 73 patients with genetically confirmed CMS who were attending the UK national referral centre for evidence of previous Severe Acute Respiratory Syndrome Corona Virus 2 infection and their clinical outcome. Of 73 patients, seven had history of confirmed COVID-19. None of the infected patients developed a severe disease, and there were no signals that CMS alone carries a high risk of severe disease from COVID-19.

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AB0450 PERIPHERAL MACROVASCULAR INVOLVEMENT IN SYSTEMIC SCLEROSIS AS COMPARED WITH HEALTHY CONTROLS: A SMALL COHORT STUDY BY COLOR AND SPECTRAL DOPPLER ULTRASONOGRAPHY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3481 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1252.2-1252

Author(s):

R. D’alessandro ◽

E. Garcia Gonzales ◽

P. Falsetti ◽

C. Baldi ◽

F. Bellisai ◽

...

Keyword(s):

Systemic Sclerosis ◽

Clinical Features ◽

Doppler Ultrasonography ◽

Power Doppler ◽

Ulnar Artery ◽

Artery Occlusion ◽

Power Doppler Ultrasonography ◽

Digital Ulcers ◽

Healthy Controls ◽

History Of

Background:Together with autoimmune-inflammation and fibrosis, microvasculopathy is a hallmark of SSc. However, also macrovascular changes may occur including peripheral proliferative vasculopathy. Whether this changes may represent a specific SSc marker with a predictive value remains a matter of debate.[1,2,3]Objectives:To study peripheral macrovascular involvement by color doppler ultrasound (CDUS) with spectral wave analysis (SWA) in a cohort of 40 SSc patients as compared to healthy controls. To further analyze any differences among the SSc population.Methods:Forty SSc patients and 36 healthy controls were examined by CDUS with SWA of both hands. Macrovascular involvement was assessed by measuring the resistivity index (RI) of distal ulnar and radial arteries. Examinations were performed with an Esaote MyLab Twice machine equipped with a linear 10-22 MHz probe. Ultrasound examination was carried out by two independent rheumatologists blinded to clinical conditions of the patients. Statistical analysis was performed by using MaxStat software.Results:The RI index resulted increased in the SSc cohort as compared with healthy controls (left ulnar RI 0.977 vs 0.715; right ulnar RI 0.996 vs 0.699; left radial RI 0.988 vs 0.706; right radial RI 0.999 vs 0.688; p<0.001). SSc patients with an increased RI in one artery were more probable to have an increased RI in the other vessels too (r 2 = 0.35; p<0.01). In addition, 8 out of 40 SSc patients presented left ulnar artery occlusion (UAO) and 7 out of 40 SSc patients presented right UAO, of which 6 presented bilateral UAO. Awaiting to enlarge the cohort for further analysis, descriptive data regarding increased RI at CDUS/SWA and clinical features, including years from onset of the disease, subtype of SSc, mRSS, history of digital ulcers, interstitial lung disease and PAH are described in Table 1.Conclusion:Peripheral macrovascular involvement was observed in SSc patients as compared with healthy controls. Further studies will determine whether this feature may have specificity for diagnosis/prognosis in SSc.References:[1]Lescoat A, Yelnik CM, Coiffier G et al. Ulnar Artery Occlusion and Severity Markers of Vasculopathy in Systemic Sclerosis: A Multicenter Cross-Sectional Study. Arthritis Rheumatol. 2019;71:983-990.[2]Lescoat A, Coiffier G, Rouil A et al. Vascular Evaluation of the Hand by Power Doppler Ultrasonography and New Predictive Markers of Ischemic Digital Ulcers in Systemic Sclerosis: Results of a Prospective Pilot Study. Arthritis Care Res (Hoboken). 2017;69:543-551.[3]Schioppo T, Orenti A, Boracchi P, De Lucia O, Murgo A, Ingegnoli F. Evidence of macro- and micro-angiopathy in scleroderma: An integrated approach combining 22-MHz power Doppler ultrasonography and video-capillaroscopy. Microvasc Res. 2019;122:125-130.Table 1.Main clinical features of the SSc cohort (n=40) studied by CDUS for macrovascular involvement.SSc cohort (n = 40)Years from onsetrange (35 y – 0 y)mean = 10.5 yAutoantibodiesACA 13/40Anti-TopoI 14/40Other 13/40mRSSrange (0 -30)mean = 3ILD17/40PAH7/40Capillaroscopy patternEarly 10/40Active 11/40Late 6/40History of digital ulcers16/40Left ulnar IR0.977Left radial IR0.988Right ulnar IR0.996Right radial IR0.999Disclosure of Interests:None declared.

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Association between severity of prenatally diagnosed hydronephrosis and receipt of surgical intervention postnatally among patients seen at a fetal-maternal center

BMC Urology ◽

10.1186/s12894-021-00822-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zoë G. Baker ◽

Arthi Hannallah ◽

Melissa Trabold ◽

Danielle Estell ◽

Cherry Deng ◽

...

Keyword(s):

Surgical Intervention ◽

Renal Scarring ◽

Tertiary Care ◽

Rank Test ◽

Kaplan Meier ◽

Hazard Ratios ◽

Age At Surgery ◽

History Of ◽

Pediatric Urologist ◽

Tract Infections

Abstract Background Hydronephrosis (HN) is the most common abnormality detected on prenatal ultrasound. This study sought to stratify outcomes of patients by severity of prenatal HN with postnatal outcomes. Methods This was a retrospective review of patients referred to a tertiary care fetal-maternal clinic with diagnosis of prenatal HN from 2004 to 2019. HN severity was categorized as mild, moderate, or severe. Data were analyzed to determine the association between HN severity and surgical intervention. Decision for surgery was based on factors including history of multiple urinary tract infections, evidence of renal scarring, and/or reduced renal function. Surgery-free survival time was represented by the Kaplan–Meier method, and hazard ratios were calculated using the log-rank test. Results 131 kidneys among 101 infants were prenatally diagnosed with hydronephrosis; 35.9% had mild HN, 29.0% had moderate HN, and 35.1% had severe HN. 8.5% of patients with mild HN, 26.3% of patients with moderate HN, and 65.2% of patients with severe HN required surgery. Patients with severe HN were 12.2 (95% CI 6.1–24.4; p < 0.001) times more likely to undergo surgery for HN than patients with mild HN and 2.9 (95% CI 1.5–5.3; p = 0.003) times more likely to undergo surgery than patients with moderate HN. Patients with moderate HN were 4.3 times more likely to require surgery than patients with mild HN (95% CI 1.5–12.9; p = 0.01). Median age at surgery was 11.8 months among patients with mild HN (IQR 11.7–14.1 months), 6.6 months among patients with moderate HN (IQR 4.2–16.4 months), and 5.4 months among patients with severe HN (3.7–12.4 months). Conclusion Among this cohort of referrals from a fetal-maternal clinic, severity of HN correlated with increased likelihood of surgical intervention. Continued assessment of patients with prenatal HN should be evaluated to best determine the role of the pediatric urologist in cases of prenatal HN.

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